Visual Symptoms Caused by Mass‐Forming Meningovascular Neurosyphilis

ABSTRACT In recent years, syphilis has re‐emerged as a significant public health concern, exhibiting a wide range of clinical manifestations, including neurological complications. Neurosyphilis mimics many neurological diseases including meningitis, parenchymal diseases, and neuropathy. Meningovascular neurosyphilis is a neurological disorder caused by vasculitis of any size in the cerebral arteries. Although it can appear in other forms, it often leads to stroke. In this report, we present the case of a 65‐year‐old man with spontaneously improving systemic skin lesions and cervical lymphadenopathy, followed by meningovascular neurosyphilis, which caused a stroke, and mass‐like lesions compressing the chiasma, leading to visual symptoms. Intravenous benzylpenicillin potassium greatly resolved the vasculitis and mass lesions, thereby contributing to a significant improvement in his neurological symptoms. This observation reinforces the notion that syphilis can present with extensive variations in its clinical presentation.